Hyperprolactinemia and sexual function in men: a short review.

Area of Science:

• Endocrinology
• Urology
• Neuroendocrinology

Background:

• Erectile dysfunction (ED) is a common symptom of hyperprolactinemia (HPRL) in men.
• HPRL can stem from pituitary tumors, posing serious health risks.
• The link between prolactin (PRL) and sexual dysfunction involves more than just testosterone levels, suggesting central nervous system mechanisms.

Purpose of the Study:

• To investigate the prevalence and significance of HPRL in men with ED.
• To explore the diagnostic challenges and screening strategies for HPRL in ED patients.
• To review the management and treatment of HPRL-induced sexual dysfunction.

Main Methods:

• Systematic review and compilation of data from over 3200 ED patients.
• Analysis of serum prolactin (PRL) levels to identify HPRL prevalence.
• Discussion of diagnostic methods, including PRL chromatography for macroprolactin identification.

Main Results:

• Marked HPRL (>35 ng/ml) was found in 0.76% of ED patients; pituitary adenomas in 0.4%.
• Macroprolactins, biologically inactive forms of PRL, account for about 10% of diagnosed HPRL and require specific identification.
• No reliable clinical or hormonal criteria exist to selectively screen ED patients for HPRL, suggesting systematic screening may be warranted.

Conclusions:

• HPRL is a serious but treatable cause of ED that warrants screening.
• Systematic serum PRL determination is recommended for ED patients due to the lack of selective screening criteria.
• Treatment for HPRL-induced sexual dysfunction includes dopamine agonists and potentially sexual counseling.